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General NPI Number Information
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NPI Number | 1548520166
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Entity Type | Organization
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Legal Business Name | LIFEWORKS RECOVERY
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 1455 AMMONS ST LOWER LEVEL
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City | LAKEWOOD
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State | CO
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Zip | 80214-6110
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Country | US
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Telephone | 303-953-3480
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Fax | 303-953-3482
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Provider Business Mailing Address
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Address Line | 1455 AMMONS ST LOWER LEVEL
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City | LAKEWOOD
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State | CO
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Zip | 80214-6110
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Country | US
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Telephone | 303-953-3480
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Fax | 303-953-3482
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. LINDA N MARTIN
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Credential | LPC, CACII
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Telephone | 303-895-5527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1674-00
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License Number State | CO
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